PCTs are responsible for ensuring that health services are provided at buildings that are fit for purpose.
But sources say some PCTs are using this power to ‘coerce' practices into PCT-owned buildings such as polyclinics. By labelling premises unfit, PCTs can remove practices' rental reimbursement, rendering many of them unviable.
Laurence Slavin, a partner with specialist medical accountants Ramsay Brown and Partners, said he knew of several PCTs using such ‘veiled threats' to force practices to move.
Dr Stuart Drage, joint chief executive of Londonwide LMCs, said that the practice was becoming increasingly common in London and other cities. ‘We never have anything hard to say it's systematic,' he said. ‘But we get whispers. People are beginning to feel vulnerable and think they're going to be forced to move.'
He cited Haringey PCT in north London as one which is using health and safety legislation to pressure practices to move. It is also using other levers such as closer performance management and remedial notices.
‘It's all very stressful,' said Dr Drage. ‘You only need one of those things to put pressure on you to the point where you cave in.' He advised practices to ensure buildings meet all regulatory standards, where possible, so as to reduce PCTs' opportunities to coerce them.
Sources close to the Darzi review increasingly believe PCTs have misinterpreted the minister's views.
Some think PCTs want to push practices into trust-owned buildings so as to increase their control of GPs. A source who attended the recent Primary Care Premises Forum, an independent body including representatives of developers, investors, solicitors and surveyors, said that PCT bosses ‘openly acknowledged' this motivation.
But Dr Peter Holden, premises lead on the GPC, warned that moving into a building owned by the PCT could create conflicts of interest.
The DoH says that it has never been policy to roll-out polyclinics outside London.
Haringey PCT said that it would not pressurise practices into polyclinics but that the location of some surgeries did not offer appropriate cover nor did they have suitable infrastructure.
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